UGC Salud Mental, Hospital Universitario Virgen Macarena, Seville, Spain; Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Spain; Departamento de Psiquiatría, Universidad de Sevilla, Seville, Spain.
Servicio de Psiquiatría, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain.
Psychiatry Res. 2022 Nov;317:114910. doi: 10.1016/j.psychres.2022.114910. Epub 2022 Oct 15.
This study examined the relationship between the prevalence of deficit schizophrenia (DS) and a country's Human Development Index (HDI). A systematic review and meta-analysis of the literature published in the last decade were conducted to acquire data on the worldwide prevalence of deficit syndrome in schizophrenia cohorts and examine the correlation between DS prevalence and the HDI of the countries in the review. Twenty-six studies meeting our eligibility criteria provided prevalence data on DS in 14 countries with both low-to-middle and high-incomes, ranging from 14.34%-to 61.57%. The pooled prevalence of DS was 32.19% (95% CI = 26.17 to 38.52). Statistical analysis yielded a correlation coefficient (r) of -0.518 (95% CI = -0.754 to -0.164; p = 0.007), indicating a moderate inverse correlation between DS prevalence and HDI. This relationship remained significant in partial correlation analysis after controlling for potential sources of bias in the DS estimates (r = -0.489, p = 0.013). Our results show that schizophrenia cohorts from low-to-middle-income countries are more prone to primary and enduring negative symptoms, and contribute to the emerging evidence questioning the axiom that schizophrenia in the developing world has a better course than in high-income countries.
这项研究考察了缺陷型精神分裂症（DS）的流行率与一个国家人类发展指数（HDI）之间的关系。对过去十年发表的文献进行了系统的回顾和荟萃分析，以获取有关世界各地精神分裂症队列中缺陷综合征流行率的数据，并研究 DS 流行率与综述中各国 HDI 之间的相关性。符合我们纳入标准的 26 项研究提供了来自 14 个高收入和中低收入国家的 DS 流行率数据，范围从 14.34%到 61.57%。DS 的总流行率为 32.19%（95%置信区间为 26.17%至 38.52%）。统计分析产生了一个相关系数（r）为-0.518（95%置信区间为-0.754 至-0.164；p=0.007），表明 DS 流行率与 HDI 之间存在中度负相关。在控制 DS 估计值中潜在偏倚源后，偏相关分析仍显示出显著的相关性（r=-0.489，p=0.013）。我们的研究结果表明，来自中低收入国家的精神分裂症队列更容易出现原发性和持续性阴性症状，这为新兴证据质疑发展中国家的精神分裂症比高收入国家的精神分裂症预后更好的假设提供了支持。
